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Normal physiology

Reviewer: Hanni Gulwani, M.D. (see Reviewers page)
Revised: 10 February 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.


● Bile excretion is normally 500-1000 ml/day
● Bile is concentrated 5-10x via active absorption of electrolytes accompanied by passive movement of water
● Cholecystokinin causes gallbladder contraction and release of stored bile into gut
● Bile is critical for intestinal absorption of dietary fat, but the gallbladder is not
● Bile is 2/3 bile salts, bicarbonate rich, has 3% organic solutes
● 95% of secreted bile salts is reabsorbed in ileum and returned to liver via portal blood, called enterohepatic circulation of bile salts
● Cholesterol is eliminated by loss of 0.5 g of bile salts per day

Bile constituents

Bile salts:
● Cholates, chenodeoxycholates, deoxycholates, lithocholates, ursodeoxycholates
● Major hepatic products of cholesterol metabolism
● A family of water-soluble sterols with carboxylated side chains
● Are highly effective detergents, solubilize water-insoluble lipids secreted by the liver (usually lecithin) into the biliary tree and promote dietary lipid absorption within the gut

Lecithin (phosphatidylcholine):
● Hydrophobic, non-aqueous
● Has minimal solubility in water

Micro images

Enterohepatic circulation

End of Gallbladder > Normal physiology

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